4 of 5 Indian children do not survive cancer. What led to this sorry state?

India has the highest prevalence of childhood cancer which can be traced to its higher population of young people, 30 per cent of its population is below 14 years, according to 2011 Census.

How long does a cancer diagnosis take?

Six months, according to Bipin Jana, 45, whose eight-year-old son Parmeshwar has stage-4 Hodgkin’s lymphoma. That is how long it took the family, travelling 2,000 km across West Bengal, New Delhi and finally, Mumbai, to get an effective diagnosis and start treatment.

Parmeshwar is currently undergoing chemotherapy at the Tata Memorial Hospital (TMH), Mumbai, India’s foremost cancer treatment centre. Almost half (43.6 per cent) of the children with cancer admitted here had to travel over 1,300 km to reach the hospital, records showed. Up to 10 per cent travelled over 2,200 km and 20 per cent had undergone alternative or incomplete treatments before reaching TMH.

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With timely diagnosis, children with cancer have a high rate of survival. If he lived in a high-income country, Parmeshwar would have had a 90 per cent chance of recovery. Since he is being treated, his odds are still better than India’s national survival rate for juvenile cancers--less than 20 per cent, according to the World Health Organization.

Worldwide, most children with cancer are from low- to middle-income countries and have poor survival rates, showed the study published in The Lancet Oncology, a global journal, in July 2019.

India has the highest prevalence of childhood cancer which can be traced to its higher population of young people, 30 per cent of its population is below 14 years, according to 2011 Census.

In order to understand why most children with cancer in India do not survive five years, IndiaSpend interviewed patients, non-governmental organisations and doctors. Delays in diagnosis, high medical expenses and non-completion of treatment are significant reasons, we found.

Survival rate can be 70 per cent with timely care

About 50,000 Indian children between 0-19 years of age suffer from cancer each year, according to The Lancet study we mentioned. “However we think the actual figure is closer to 75,000,” said Girish Chinnaswamy, head oncologist at the TMH.

Approximately 20,000 children remain undiagnosed and untreated and their survival rate is 0 per cent, he said. “For the 55,000 who are accessing treatment, 15,000 are receiving a good standard of treatment with trained oncologists as well as social, dietary and financial support and this group has a survival rate of 70 per cent,” he said.

Google's AI system better than humans at spotting lung cancer: Study

According to a researcher the AI is essentially 4D since it's looking at two CT scans at a time compared to a human who can look at only one.

Business Standard : Scientists at Google have developed an artificial intelligence (AI) model which they claim is better at diagnosing lung cancer than human experts, an advance that could lead to earlier treatments for the deadly disease.

Deep learning -- a form of AI -- was able to detect malignant lung nodules on low-dose chest computed tomography (LDCT) scans with a performance meeting or exceeding that of expert radiologists, researchers said.

The system, described in the journal Nature Medicine, provides an automated image evaluation system to enhance the accuracy of early lung cancer diagnosis that could lead to earlier treatment.

The deep-learning system was compared against radiologists on LDCTs for patients, some of whom had biopsy confirmed cancer within a year. In most comparisons, the model performed at or better than radiologists.

Deep learning is a technique that teaches computers to learn by example.

The deep-learning system also produced fewer false positives and fewer false negatives, which could lead to fewer unnecessary follow-up procedures and fewer missed tumours, if it were used in a clinical setting.

"Radiologists generally examine hundreds of two-dimensional images or 'slices' in a single CT scan but this new machine learning system views the lungs in a huge, single three-dimensional image," said Mozziyar Etemadi, a research assistant professor at Northwestern University in the US.

"AI in 3D can be much more sensitive in its ability to detect early lung cancer than the human eye looking at 2D images. This is technically '4D' because it is not only looking at one CT scan, but two over time," Etemadi said.

"In order to build the AI to view the CTs in this way, you require an enormous computer system of Google-scale. The concept is novel but the actual engineering of it is also novel because of the scale," he said.

This research is incredibly important, as lung cancer has the highest rate of mortality among all cancers, and there are many challenges in the way of broad adoption of screening, said Shravya Shetty, technical lead at Google.

"Our work examines ways in which AI can be used to improve the accuracy and optimise the screening process, in ways that could help with the implementation of screening programs. The results are promising

A cure for HIV? Case studies show feasible treatments not yet realised

The treatment involves destroying a person's own immune system with high doses of chemotherapy or radiation. Then the patient receives a transplant of new stem cells from either themselves or a donor.

Business Standard : This week a team of scientists and physicians from the U.K. published news of a second HIV positive man, in London, who is in long-term (18-month) HIV remission after undergoing treatment for Hodgkins lymphoma. The unexpected success has launched a new round of discussion about a potential cure for HIV.

Since 2008, scientists have been trying to replicate the treatment that cured the “Berlin patient” of HIV. At the time, many in the field of HIV research were excited to learn that this man, who tested positive for the human immunodeficiency virus in Berlin and had recently undergone treatment for acute myeloid leukemia, appeared to have been cured of his HIV. Until now, success in replicating that cure has been limited.

What is HIV?

HIV is the virus that causes AIDS. Since the virus was first discovered in the 1980s, more than 75 million people worldwide have been infected with HIV. Today, almost 37 million people live with HIV. Of these, about 1.1 million live in the U.S.

Infection with HIV almost always led to AIDS, which in turn was almost always fatal. The field was revolutionized in 1996 with the introduction of HIV anti-retroviral therapy medications. These drugs halt HIV from replicating and allow an infected person to regain a functioning immune system. These medications are so effective that today a person living with HIV has almost the same life expectancy of someone without HIV infection. However, these medications must be taken every day, have multiple distressing side effects, and can cost thousands of dollars each month.

Yet even with this life-extending treatment, a functional HIV cure, defined as when someone with HIV no longer tests positive for the virus and does not need to take these medications, has remained elusive.

The ‘cure’ treatment

All of that seemed to change when in 2008 at the Conference on Retrovirus and Opportunistic Infections in Boston, Massachusetts, the news broke of the Berlin patient, named Timothy Ray Brown, who seemed to have been cured of his HIV. In order to achieve that serendipitous “cure,” Brown had to undergo aggressive treatment for his acute myeloid leukemia that involved two hematopoietic stem cell transplantations – in which a patient’s bone marrow is damaged – and full body irradiation.

This complex treatment involves destroying a person’s own immune system with high doses of chemotherapy or radiation. Then the patient receives a transplant of new stem cells from either themselves or a donor.

This is a difficult treatment that carries a high risk of infection and other complications, such as graft-versus-host disease, blood clots and liver disease.